This is contained in a report by WHO Regional Director for Africa, Dr Ebrahim Samba, on scaling up access to HIV/AIDS care and treatment under the "3 by 5" Initiative which aims at reaching three million people needing antiretroviral therapy worldwide by the year 2005.

The report, to be discussed at the fifty-fourth session of WHO Regional Committee for Africa taking place from 30 August to 3 September in Brazzaville, Congo, urges governments to take action to lower the cost of medicines and diagnostics and provide care and treatment for health care workers. It, however, warns that "implementing these interventions…should not detract from prevention as the most important key response to HIV/AIDS".

The report identifies some of the key challenges to be addressed in improving access to care and treatment. These include the development and implementation of comprehensive plans, the expansion of geographic coverage, the establishment of effective mechanisms for mobilization and coordination, and capacity strengthening. Others are increased uptake of testing and treatment services, stigma reduction, adherence to long-term treatment and the reduction of the price of quality medicines and diagnosis. …/1 Other challenges are the treatment needs of women, adolescents and children; the availability of adequate resources and the improved monitoring of care.

Dr Samba also pledges WHO support to Member States for the development, implementation, monitoring and evaluation of care and treatment plans, as well as continued advocacy for more external resources and the facilitation of partnerships.

Africa is the region worst hit by the HIV/AIDS pandemic. At the end of 2003, a total of 40 million people globally were infected with HIV, and 67% of these were living in sub-Saharan Africa. Women and young people aged 15 to 24 are disproportionately infected. The epidemic has reversed decades of gradual gains in life expectancy in Africa which now has a new low life expectancy of under 46.

WHO estimates that out of an estimated four million people in need of antiretroviral therapy (ART) in sub-Saharan Africa, only 100,000 have access. Estimated coverage of services for prevention of mother-to-child transmission and voluntary counselling and testing are 1% and 6%, respectively. More than 70% of countries in the region do not have ART programmes.